Special Issues in Counseling Lesbian Women for Sexual Addiction, Compulsivity, and Sexual Codependency

While much of the knowledge and interpersonal skills needed to counsel lesbian women are the same as for counseling heterosexual women, there are numerous additional dynamics and concerns that need to be addressed. These include: understanding the patterns of sexual addiction in lesbian relationships; a basic knowledge of issues lesbian women face in their daily lives; internalized oppression (the absorption of negative cultural stereotypes), the lack of cultural support for lesbian relationships, homophobia, the oppression -avoidance syndrome, typical sexual difficulties in lesbian relationships, subculture dynamics, and the coming out process. In addition, therapists needs to explore their own questions, fears, and fantasies of lesbian relationships, life style, and sexuality that can manifest in countertransference issues that are often more subtle and unconscious than therapists realize. While some of the material presented here is not specific to sexual addiction and codependency, it is all relevant because it lays the groundwork to form a trusting client-therapist relationship where a lesbian woman feels safe to explore her addictive issues. This material helps form a backdrop of knowledge that gives therapists a context for understanding lesbian oppression and its impact on sexuality, dependency, and building primary sexual relationships. This does not suggest that therapists analyze all problems based on oppression, but rather that they have a broad understanding that can help facilitate a meaningful integration of this knowledge with the presenting problems of their clients.